Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Department of Interventional Radiology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China.
Cardiovasc Intervent Radiol. 2020 Sep;43(9):1294-1304. doi: 10.1007/s00270-020-02519-0. Epub 2020 May 20.
To estimate the prognostic significance of the controlling nutritional status (CONUT) in patients with BCLC stage A hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA).
From January 2013 to December 2016, 325 patients with BCLC stage A HCC who underwent RFA at the National Cancer Center and First Hospital of Shanxi Medical University were retrospectively studied. The patients were divided into low (≤ 4) and high (≥ 5) CONUT scores for assessment of overall survival (OS) and recurrence-free survival (RFS). Several covariates, including age, sex, the diameter and number of lesions, lesion differentiation, Child-Pugh class, hepatitis B virus infection, along with blood levels of AFP, AST, ALT, γ-GT, and TBIL, were assessed using univariate and multivariate analyses.
The mortality rate was 17.49% (46/263) and 35.48% (22/62) in the low and high CONUT groups, respectively, with the difference being statistically significant (P = 0.033). In addition, disease recurrence was significantly higher in the high CONUT group at 70.97%, as compared to the low CONUT group at 43.35% (P = 0.041). The predictive factors were used to build the nomogram to estimate 1-, 3- and 5-year OS and RFS rates.
CONUT scores were found to be associated with the prognosis of patients with early-stage HCC who underwent RFA. Higher CONUT scores were associated with poor survival outcomes.
评估控制营养状况（CONUT）评分在巴塞罗那临床肝癌分期（BCLC）A 期肝癌患者射频消融（RFA）后的预后意义。
回顾性分析 2013 年 1 月至 2016 年 12 月在国家癌症中心和山西医科大学第一医院接受 RFA 治疗的 325 例 BCLC A 期 HCC 患者。将患者分为低（≤4）和高（≥5）CONUT 评分组，评估总生存（OS）和无复发生存（RFS）。使用单因素和多因素分析评估了年龄、性别、肿瘤直径和数量、肿瘤分化程度、Child-Pugh 分级、乙型肝炎病毒感染以及 AFP、AST、ALT、γ-GT 和 TBIL 等血液水平等多个协变量。
低 CONUT 组和高 CONUT 组的死亡率分别为 17.49%（46/263）和 35.48%（22/62），差异具有统计学意义（P=0.033）。此外，高 CONUT 组的疾病复发率显著高于低 CONUT 组（70.97%比 43.35%，P=0.041）。采用预测因素构建列线图，以估计 1、3 和 5 年的 OS 和 RFS 率。
CONUT 评分与接受 RFA 的早期 HCC 患者的预后相关。较高的 CONUT 评分与较差的生存结局相关。
